Dr. Kimsung Hawks
Director
Healthcare Compliance, Medicare/Medicaid, Clinical Program Development
RN, Ph.D., HS-BCP
Dr. Kimsung Hawks possesses over 30 years of clinical leadership and healthcare industry experience. Dr. Hawks has held consistent professional roles at the national level, building clinical programs and interfacing with various levels of state and federal stakeholders. She has over 12 years of combined quality experience and has worked in private industry and state and federal governments.
Kimsung is an expert in conducting onsite inspections of healthcare delivery provided to beneficiaries to evaluate the quality of care, quality of life, and the provision of essential services, in compliance with federal and state statutes and regulatory requirements at long-term care facilities, group homes, assisted living facilities, home health solutions, and respite care programs. She has expertise in using and evaluating various statutory tools such as the Outcome and Assessment Information Set (OASIS) to ensure home health agencies integrate into the patient’s comprehensive care plan; the Resident Assessment Instrument (RAI) to ensure that facilities are addressing the whole person (person-centered care), the Minimum Data Set (MDS) and other state-specific instruments used for audits. She is a subject matter expert in identifying and reporting sentinel events, developing corrective actions, and working with other components to address risk management issues. Her expertise in data analysis and crafting narratives and reports align with the tools used to address facility-based care.
Previously, Kimsung served as National Director of Clinical Program Development for UnitedHealthcare where she performed clinical program development, creating P&Ps based on the latest clinical practice guidelines and standards of care, and marshalling the integration of physical and behavioral health. She also developed and implemented national health initiatives.
Addionally, Dr. Hawks has advised facilities on best practices and technical assistance and partnered with the Department of Social Services to advise and refer to appropriate services and supports. Her appeal rate was 99% successful at the Virginia Department of Health, Suffolk. She is an expert on the nursing process, assessment, and development of plans of care.
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2550 E Rose Garden Ln.
Unit 72016
Phoenix, AZ 85050
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